Getting dental care is essential for maintaining good oral health, but it also has a number of other, far-reaching benefits. Healthy teeth and gums, for example, are an important part of keeping the rest of your body healthy, and regular cleanings can prevent costly fillings and root canals.

Unfortunately, fewer and fewer adults are going to the dentist. In 2016, only 64.4% of working-age adults visited the dentist. While the reasons for this are diverse and differ over income levels, age, and insurance status, the research shows common threads, several of which are simply out of patients’ hands, making it difficult for them to get the care that they deserve.

If you find yourself struggling to get dental care, you’re not alone. Here are Dr. Khodadoust’s 3 most common reasons people don’t get dental care—and what you can do to help yourself get the care you need.

1. Their Teeth are Healthy

Many adults simply feel that they have a healthy mouth and don’t need dental care. The truth is, however, that many oral health issues are painless until it’s too late to avoid a big procedure. If you’re experiencing a toothache, you probably already need a major filling or root canal—pain means decay has likely already reached the nerves in your tooth.

Few people realize that it’s possible to pass on cavity-causing bacteria to your kids or spouse by sharing food and drinks, so an undetected cavity could negatively affect other members of your family. Additionally, gum disease is often painless, and a staggering number of Americans suffer from it; at its worst, it can cause you to lose teeth.

This is why the preventative measures at a dentist’s office are so important. Dentists can clean areas that are hard for you to reach at home, scrape off tartar buildup, and spot issues before they become major problems that require expensive procedures. Just like any area of your body’s health, it’s better to take preventative measures early than to only treat issues once they become big enough to be noticeable.

2. They Can’t Afford it

This is one of the biggest reasons adults are unable to get access to dental care. In an ADA survey, 40.2% of adults who indicated they wouldn’t be going to the dentist in the next year listed cost as the reason. Unfortunately, this can create a bit of a Catch-22 for many patients. Going to the dentist every six months when you’re not experiencing discomfort can seem like irresponsible spending, especially when you can’t spare much from your budget.

On the other hand, many serious dental issues can fly under the radar until it’s too late to avoid a major procedure. Putting the dentist off to save some money now could lead to a much larger bill for a root canal and crown or treatment for gum disease later, but you can’t let those larger issues fester, either. Aside from the pain and lasting damage to your teeth, allowing decay or gum disease to go untreated carries its own risks, such as an increased risk for heart attacks, strokes, and diabetes. These issues can mean a major bill—much more than it would cost to go to the dentist for a regular checkup.

Thankfully, there’s an upside. Many dentists’ offices are willing to work with you if you’re struggling to pay your bills all at once. Rather than paying in a lump sum, you can work out a payment plan that allows you to pay the bill in smaller installments. You can also discuss how often you need to visit the dentist Although the general recommendation is six months, some people can go a little bit longer. This can make all the difference in ensuring you get the care you need, preventing larger issues in the future, in a way that you can afford.

3. They are Scared

It’s pretty common for people to dread going to the dentist, but for some people this anxiety is so severe that they’ll avoid it altogether. If you’re terrified of the dentist and only show up when you’re in pain, though, this means that all of your experiences at the dentist will be more negative. Fillings, root canals, and other extensive treatments will be more common in your experience at the dentist, which will only worsen your anxiety.

Thankfully, there are tactics you can use to make the dentist as low-stress as possible. You may feel embarrassed, but dentists see patients who suffer from anxiety all the time. Inform them of your anxiety and discuss hand signals with the dentist and dental hygienist so that you can let them know if you need a break. Some people find that having the dentist explain exactly what they’re doing helps their anxiety; if so, this is an easy accommodation your dentist can make for you. You can also practice deep breathing exercises and ask to play some music or watch TV in the room while the dentist works. If your dentist doesn’t take your anxiety seriously, it’s okay to find a different dentist who will; doing so is simply advocating for yourself. You deserve the best care, and a dentist who doesn’t take your anxiety seriously will never be able to provide that for you, regardless of their skill level.

Although there are a variety of factors that can make it hard for you to go to the dentist, most dentists are willing and able to accommodate your needs. Advocating for yourself is easier than ever with the advent of the internet; whether you have anxiety that your dentist needs to be sensitive to or need a payment plan that fits your budget, being informed about your options and advocating for yourself can help you ensure that you get the best care available with the accommodations you need.

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